The 2019 legislative session of the Connecticut General Assembly produced a number of new statutes that impact hospitals and other health care providers, many of which are scheduled to take effect on October 1. These Public Acts add new disclosure and testing requirements for hospitals, expand the responsibilities and regulation of non-physician practitioners and continue to address the problem of opioid abuse.
Listed below are descriptions of key statutes that hospitals and licensed practitioners should be aware of:
Trauma Activation Fees
Short-term and acute care hospitals designated by the state as trauma centers can charge an additional fee when a trauma team is called to attend to a patient with life-threatening injuries. A new law requires these hospitals to report to the Health Systems Planning Unit of the Office of Health Strategy (“OHS”) information that OHS prescribes regarding these trauma activation fees. The new information will be reported along with the annual reports that OHS requires of all short-term and acute care hospitals pursuant to Connecticut General Statutes (“CGS”) 19a-644(a). (PA 19-117, §245)
Non-Physician Practitioners
New laws affecting individual health care providers include the following:
- The scope of practice for advanced practice registered nurses is expanded. For example, an APRN may: enter into a collaborative drug therapy management agreement with a pharmacist; treat an injured employee involved in a workers’ compensation case; and diagnose significant changes in a patient’s diabetes symptoms for purposes of requiring insurers to cover medically necessary outpatient self-management training and education. In addition, APRNs certified as psychiatric mental health providers by the American Nurses Credentialing Center may authorize emergency treatment for a child hospitalized for psychiatric disabilities if parental consent is withheld or immediately unavailable and the APRN determines that treatment is necessary to prevent serious harm. (PA 19-98)
- Pharmacists are required to offer consultations to patients when dispensing a prescription regarding a drug and usage of the drug. The pharmacist must keep a record of the counseling; any refusal by or inability of the patient to accept counseling; or a refusal by the patient to provide information regarding the counseling. The pharmacist may make a written offer to consult if he/she deems it appropriate; the written offer must give the patient the option to consult in person or by phone. Current law requires similar consultations only for Medicaid patients under CGS §20-620. (PA 19-191, §1)
- Under current law, students who graduate with an advanced degree in professional counseling or marital and family therapy may practice without a license in order to complete the supervised work experience required for licensure. A new law eliminates these provisions and establishes new associate licenses that students must obtain before they can practice under professional supervision while pursuing full licensure. (PA 19-117, §§162-182)
- Under current law, art therapists are not licensed. A new law creates a licensure program for art therapists to be issued by the Connecticut Department of Public Health (“DPH”). The law allows DPH to issue a temporary permit to an applicant for licensure to practice art therapy under supervision. (PA 19-117, §§ 176-180)
- Beginning October 1, 2019, a new law prohibits use of the title “social worker” unless an individual is licensed. An exemption exists for certain state and municipal employees. (PA 19-164)
- The General Assembly approved new certification and continuing education requirements for emergency medical responders; emergency medical technicians; and advanced emergency medical technicians. For example, beginning January 1, 2020, persons seeking these certifications must have passed an examination administered by a national organization for emergency medical certification and must have received mental health first aid training as part of a program provided by an instructor certified by the National Council for Behavioral Health. Recertification must occur every two years, not three years as under current law. Applicants for licensure as a paramedic applying on and after January 1, 2020 must also receive mental health first aid training. (PA 19-191, §10)
- A bill enacted during the 2018 legislative session changes the number of required classroom hours and length of the clinical experience that applicants for the massage therapy license must complete. The law also requires that licensed massage therapists who provide direct patient care services maintain professional liability insurance. (PA 18-168, §§63 and 65)
Opioids
Governor Lamont signed into law a number of statutes aimed at combating the opioid crisis, including the following with effective dates of October 1, 2019:
- A law requiring practitioners who prescribe more than a 12-week supply of an opioid drug for the treatment of pain to establish a treatment agreement or discuss a care plan for chronic opioid use. The law specifies the elements of the treatment agreement or care plan and requires that a record of the treatment agreement or care plan be included in the patient’s medical record. (PA 19-191, §6)
- Beginning January 1, 2020, a requirement that hospitals administer a mental health screening or assessment, if medically appropriate, to patients treated for a nonfatal opioid drug overdose. Results must be provided to the patient or patient’s parent/guardian, as medically appropriate. (PA 19-191, §11)
- A requirement that substance use treatment programs operated or approved by the Department of Mental Health and Addiction Services educate patients with opioid use disorder on opioid antagonists and how to administer them. If a prescribing practitioner is affiliated with the program, he or she must issue a prescription for or deliver at least one dose of an opioid antagonist to the patient within certain timeframes if the prescriber determines that the patient would benefit from it. The relatives and significant other of the patient must also be offered education if these individuals have been identified by the patient. (PA 19-191, §9)
- A law requiring that inmates who identify as suffering from, or relapsing into, opioid use disorder and who are scheduled to be released from the custody of the Commissioner of Correction receive information regarding treatment options and how to access such options after release, not later than 45 days before the scheduled release. (PA 19-167)
- A law granting civil immunity to entities and individuals who include an opioid antagonist within a cabinet containing an automatic external defibrillator. The immunity applies to acts or omissions constituting ordinary negligence in making the opioid antagonist available. The immunity does not apply to acts or omissions constituting gross, willful or wanton negligence. (PA 19-169)
- A law providing that no life insurance or annuity policy may be delivered in Connecticut that excludes coverage solely on the basis of an individual’s receipt of a prescription for naloxone. (PA 19-191, §5)
- A law requiring drug manufacturers and wholesalers to report to the Connecticut Department of Consumer Protection their decisions, based on concerns of potential diversion, to terminate or refuse an order from a pharmacy or prescribing practitioner for Schedule II to V controlled substances. (PA 19-191, §4)
- Classification of fentanyl (and any salt, compound, derivative or preparation of fentanyl) as a “narcotic substance,” meaning that the penalties for certain illegal actions involving fentanyl will be higher than the penalties for such actions involving non-narcotic substances. (PA 19-38)
Civil Immunity for Use of Automatic External Defibrillators (“AEDs”)
Physicians, dentists, nurses and LPNs who operate an AED are granted civil immunity for personal injuries resulting from a malfunction of the AED, provided the malfunction was not a result of the health care provider’s negligence. (PA 19-113)
Newborn Testing
New test requirements for newborns include:
- A test for disorders included on the federal Recommended Uniform Screening Panel as amended from time to time, subject to the approval of the Secretary of the Office of Policy and Management. (PA 19-117, §148)
- A screening test for spinal muscular atrophy, unless the parents object to the test as being in conflict with their religious tenets and practice. This test is required beginning January 1, 2020. (PA 19-176)
